The ACA is anything but. Obamacare has cost the lives of rural patients who couldn’t make it to the hospital within the golden hour because Obamacare led to the closing of their closest hospital. Surely there was room in the article to mention the underlying causes and fatal effects of these closures in the interest of fullest possible public awareness.

Timothy Michael

And here is the version of my LTE that was published this morning (July 3rd) in the Daily Star.

Hospitals close for many complex reasons

Re the June 19th letter "Affordable Care Act is anything but affordable."

The sources mentioned all report closures since 2010 to be less than 50. The better source is the University of North Carolina rural health research program which has 90 hospital closures in its database. Of those, 37 occurred before 2010 and 53 occurred after the beginning of 2010.

However, the pattern is different for those states that expanded Medicaid (23 dropping to 14) and those that did not (14 increasing to 39). Thus states that expanded Medicaid experienced a 40 percent drop in closures, but states that refused the Medicaid expansion saw their closure rates increase by nearly 180 percent. That disparity resulted from decisions made by state governments.

The possible causes of rural hospital closures are many and complex. Blaming a single agent, as the writer does, reflects an ideological bias not supported by facts.

Note: Here is an important line from my submission that did not make it into the letter as published.The Washington Post notes that "... rural hospitals ... suffer from multiple endemic disadvantages that drive down profit margins and make it virtually impossible to achieve economies of scale."

Originally I submitted an op-ed piece to the Star that closed with this paragraph.

Let me end with a plea for a tighter editorial review of letters claiming to provide factual information. I will readily admit that I am a numbers guy by training and profession. But Michael's false numerical claims can be disproved easily by anyone doing a simple Google search as I did. The Star owes more to its readers than reprinting misinformation.

I was warned by a critical reader that the admonition would be a death sentence for publication. The reader was right. But I stand by my message. "The writer," Michael, invented his numbers so as to bend the facts to his ideological bias. Making the claim of "hundreds" of closures took his letter from an opinion piece into the realm of reporting a "fact." That deserved a fact-check that did not occur. We need better from our media.